Mapping patient goals to the International Classification of Functioning, Disability and Health (ICF): examining the content validity of the low back pain core sets.

Abstract

OBJECTIVE: To determine whether the International Classification of Functioning, Disability and Health (ICF) Low Back Pain Core Sets are sufficient to cover the activity and participation goals that patients prioritize when commencing multidisciplinary rehabilitation. DESIGN: Prospective multi-site cross-sectional questionnaire study. SUBJECTS: Patients with chronic low back pain attending multidisciplinary outpatient clinics at two metropolitan hospitals in Australia. METHODS: Participants used the Patient Specific Functional Scale to record goals when commencing rehabilitation. Two raters employed a standardized procedure to extract and link goal concepts to the ICF. A description exploration was undertaken with reference to the low back pain Core Sets. Sample size was determined via saturation. RESULTS: Saturation was achieved with 33 participants. Ninety five goals were identified, from which 109 concepts were extracted. All of the concepts could be linked to the ICF, spanning 23 2nd-level categories. The comprehensive and brief core sets encompassed 95% and 65% of the concepts respectively. Maintaining body position (d415), doing housework (d640), changing basic body position (d410) and walking (d450) accounted for the majority (50.5%) of goals. CONCLUSION: This study confirms the content validity of the low back pain Core Sets from the patients' perspective. The Core Sets are likely to have good clinical utility, however, additional research is required to substantiate whether ratings of ICF based goals can be used to measure goal achievement.